| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Facility | $3,187.61 | $3,187.61 | $3,187.61 | |
Cigna
| Professional | $3,187.61 | $3,187.61 | $3,187.61 | |
Providence
| Facility | $3,187.61 | $3,187.61 | $3,187.61 | |
Providence
| Professional | $1,978.52 | $1,978.52 | $3,187.61 | |
United
| Professional | $923.31 | $923.31 | $2,198.35 |